Provider Demographics
NPI:1407966922
Name:RYAN, NANCY MARGARET (MS RD CDE CD N)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:MARGARET
Last Name:RYAN
Suffix:
Gender:F
Credentials:MS RD CDE CD N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 W PUTNAM AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5329
Mailing Address - Country:US
Mailing Address - Phone:203-622-4416
Mailing Address - Fax:
Practice Address - Street 1:159 W PUTNAM AVE FL 2
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830
Practice Address - Country:US
Practice Address - Phone:203-622-4416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000181133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
710000028Medicare ID - Type Unspecified